MyMedi-AI

L6900 — Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining

HCPCS Level II L-code · short descriptor: “Hand restorat thumb/1 finger”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L6900 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1849.18 to $2681.07 depending on state and rural status.

Former-CBA payment limits: ceiling $2465.57 · floor $1849.18

StateNon-ruralRural
AK$2507.26—
AL$2186.02—
AR$1892.87—
AZ$2455.98—
CA$2455.98—
CO$1849.18—
CT$1849.18—
DC$1966.93—
DE$1966.93—
FL$2186.02—
GA$2186.02—
HI$2681.07—
IA$2418.60—
ID$2377.15—
IL$2387.98—
IN$2387.98—
KS$2418.60—
KY$2186.02—
LA$1892.87—
MA$1849.18—
MD$1966.93—
ME$1849.18—
MI$2387.98—
MN$2387.98—
MO$2418.60—
MS$2186.02—
MT$1849.18—
NC$2186.02—
ND$1849.18—
NE$2418.60—
NH$1849.18—
NJ$2173.00—
NM$1892.87—
NV$2455.98—
NY$2173.00—
OH$2387.98—
OK$1892.87—
OR$2377.15—
PA$1966.93—
PR$2172.94—
RI$1849.18—
SC$2186.02—
SD$1849.18—
TN$2186.02—
TX$1892.87—
UT$1849.18—
VA$1966.93—
VI$2173.00—
VT$1849.18—
WA$2377.15—
WI$2387.98—
WV$1966.93—
WY$1849.18—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L6900 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

Bill L6900 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, L6900 included, and starter credits via POST /bot-marketplace/register.